Jeffrey Wade
In Oklahoma, Medicaid is called SoonerCare, and it is jointly funded by the state and federal government. The Oklahoma Department of Human Services (OKDHS) is the agency that administers the program. OKDHS Live is the online portal where individuals can apply for SoonerCare. The program offers health insurance to low-income individuals of all ages, including the elderly, disabled, pregnant women, children, and parents. While Medicaid eligibility criteria vary based on factors like income, marital status, and medical needs, applicants can determine their eligibility through a free Medicaid Eligibility Test offered by the American Council on Aging.
| Characteristics | Values |
|---|---|
| Name of Medicaid in Oklahoma | SoonerCare |
| Administering Agency | Oklahoma Department of Human Services (OKDHS) |
| Type of Program | State/Federal |
| Coverage | Medical expenses for certain groups with limited income and resources |
| Eligibility | Aged, blind, disabled, parents, pregnant women, children under 19, women with breast or cervical cancer, non-elderly adults |
| Income Requirements | Vary based on eligibility category |
| Asset Requirements | Vary based on eligibility category |
| Application Channels | Online, Phone, In-Person |
| Application Assistance | SoonerCare Helpline, OKDHS Local County Office, Director's Helpline, Local Area Agency on Aging |
| Additional Programs | Money Follows the Person (Living Choice Program), Insure Oklahoma |
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What You'll Learn
Medicaid eligibility criteria in Oklahoma
In Oklahoma, Medicaid is called SoonerCare. The program is jointly funded by the state and federal governments but is administered by the state under federally set parameters. The Oklahoma Department of Human Services (OKDHS) is the administering agency.
Medicaid is a health care insurance program for low-income individuals of all ages. There are three categories of Medicaid long-term care programs for which Oklahoma seniors may be eligible:
- Institutional / Nursing Home Medicaid: An entitlement; anyone who is eligible will receive assistance. Benefits are provided only in nursing homes.
- Medicaid Waivers / Home and Community-Based Services (HCBS): This is not an entitlement and has a limited number of participants due to enrollment caps. Therefore, waiting lists may exist. It is intended to delay the need for nursing home admissions, and assistance is provided at home, adult day care, or in assisted living.
- Money Follows the Person: Also called the Living Choice Program in Oklahoma. This federal program helps institutionalized persons who are eligible for Medicaid to transition back home or into the community.
The three categories of Medicaid long-term care programs have differing financial and medical eligibility criteria. The financial criteria change annually, vary with marital status, and Oklahoma offers multiple pathways towards eligibility. For instance, persons who have excess income and/or assets should consider Medicaid Planning. One option is to deposit money into a Qualified Income Trust (QIT). The income cap for a QIT is $7,445/month, effective 7/1/24. Another option is to spend down assets on non-countable items, such as home or vehicle modifications.
In general, the following populations are eligible for SoonerCare Medicaid in Oklahoma:
- Adults under age 65 with household income up to 138% of the poverty level
- Pregnant women with household income up to 210% of the poverty level
- Children in households with income up to 210% of the poverty level
- Adults age 65 and older, and people with disabilities: Eligibility depends on both income and assets
- Adults, not eligible for Medicare, aged 19-64
- Individuals who were enrolled in Medicaid and who aged out of foster care (at 18 years old) in another state, on or after January 1, 2023
- Women under 65 who need treatment for breast or cervical cancer
Elderly individuals can apply for SoonerCare in Oklahoma online at OKDHSLive! or through the Department of Human Services. They can also call the Director’s Helpline at 877-751-2972 or 405-521-2779.
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Applying for Medicaid in Oklahoma
In Oklahoma, Medicaid is called SoonerCare. The program is jointly funded by the state and federal government and administered by the state under federally set parameters. The Oklahoma Health Care Authority is responsible for collecting the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of health care, and processing of claims. This data is treated as confidential and securely stored in accordance with applicable laws and regulations.
To apply for Medicaid in Oklahoma, you must meet the eligibility criteria, which vary based on the specific program for which you are applying. The three categories of Medicaid long-term care programs are:
- Institutional/Nursing Home Medicaid: This is an entitlement, meaning that anyone who is eligible will receive assistance. However, benefits are only provided in nursing homes.
- Medicaid Waivers/Home and Community-Based Services (HCBS): This is not an entitlement, and there are enrollment caps, which may result in waiting lists. This program aims to delay the need for nursing home admissions by providing assistance at home, adult day care, or assisted living facilities.
- Money Follows the Person: Also known as the Living Choice Program in Oklahoma, this federal program assists institutionalized persons eligible for Medicaid in transitioning back to their homes or communities.
In addition to these three categories, Medicaid in Oklahoma also covers medical expenses for specific groups, including low-income pregnant women, children, individuals who are elderly or have disabilities, parents, and women with breast or cervical cancer.
You can apply for SoonerCare online through the Oklahoma Health Care Authority website or by downloading and mailing in an application form in English or Spanish. Alternatively, you can apply in person at your local county DHS office. Before submitting your application, ensure you meet the eligibility criteria, especially regarding income and assets. If you require assistance with the application process, you can call the SoonerCare Helpline at 1-800-987-7767.
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Medicaid long-term care programs
In Oklahoma, Medicaid is called SoonerCare. The program is jointly funded by the state and federal government and administered by the Oklahoma Department of Human Services (OKDHS).
The three categories of Medicaid long-term care programs in Oklahoma are:
- Institutional / Nursing Home Medicaid: This is an entitlement, meaning anyone who is eligible will receive assistance. Benefits are provided only in nursing homes.
- Medicaid Waivers / Home and Community-Based Services (HCBS): This is not an entitlement, and there are a limited number of participants due to enrollment caps. This program intends to delay the need for nursing home admissions, and assistance is provided at home, adult day care, or in assisted living.
- Money Follows the Person: Also called the Living Choice Program in Oklahoma, this federal program helps institutionalized persons who are eligible for Medicaid to transition back home or into the community.
To be eligible for long-term care Medicaid in Oklahoma, seniors must meet specific financial and medical criteria. For 2025, a single nursing home Medicaid applicant must have an income under $2,901 per month, assets under $2,000, and require a nursing home level of care.
In New York, long-term care services may include medical, social, housekeeping, or rehabilitation services that an individual needs over an extended period to maintain or improve their health. These services are provided in nursing homes, patients' homes, or community-based settings such as assisted living facilities. New York offers a Managed Long-Term Care (MLTC) program, which streamlines the delivery of long-term services to people who are chronically ill or disabled and wish to remain in their homes and communities. Enrollment in an MLTC plan may be mandatory or voluntary, depending on individual circumstances.
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Cancelling Medicaid insurance
In Oklahoma, Medicaid is called SoonerCare. The program is jointly funded by the state and federal government and is administered by the Oklahoma Department of Human Services (OKDHS).
To cancel your Medicaid insurance, you must go through your state's healthcare department. The process for cancelling Medicaid is different for MAGI, Classic, and Managed Care benefits. You may qualify for Medicaid because your modified adjusted gross income (MAGI) is below the government threshold, or for another reason such as age (over 65) or disability.
If you have an account online on your state's health care marketplace website, you may be able to cancel your Medicaid coverage through that account. If you don't have an account but want to cancel your Medicaid online, you can follow the prompts to set up an account first. Once your account is verified, you should be able to use it to cancel your coverage.
When you cancel your coverage, check the final date that you'll be covered under Medicaid to ensure there is no gap between your Medicaid insurance ending and your new insurance coverage starting. You will receive a written notification of your cancellation by mail. Once you've cancelled your Medicaid, your state Medicaid office will send you written confirmation of the cancellation. Review the notice and make sure all the information on it is correct.
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Medicaid insurance for seniors
Medicaid is a state-federal program that provides health coverage to low-income individuals, including seniors. In Oklahoma, it is called SoonerCare. While the program is jointly funded by the state and federal government, it is administered by the state under federally set parameters. The Oklahoma Department of Human Services (OKDHS) is the administering agency.
Medicaid programs vary from state to state and may have different names, such as "Medical Assistance" or "Medi-Cal." In Oklahoma, seniors can apply for SoonerCare online at OKDHSLive! or through the Department of Human Services. The American Council on Aging offers a free and quick Medicaid Eligibility Test for seniors. The financial criteria for eligibility change annually and vary with marital status, and Oklahoma offers multiple pathways towards eligibility. For instance, money deposited into a QIT does not count towards Medicaid's income limit, and individuals with excess income and/or assets can become eligible by spending excess assets on non-countable items, such as home or vehicle modifications.
There are three categories of Medicaid long-term care programs for which Oklahoma seniors may be eligible:
- Institutional/Nursing Home Medicaid: An entitlement where benefits are provided only in nursing homes.
- Medicaid Waivers/Home and Community-Based Services (HCBS): Not an entitlement; there is a limited number of participants due to enrollment caps, so waiting lists may exist. Assistance is provided at home, adult day care, or in assisted living to delay the need for nursing home admissions.
- Money Follows the Person: Also called the Living Choice Program in Oklahoma. This federal program helps institutionalized persons who are eligible for Medicaid to transition back into the community or their homes.
Medicaid can help low-income seniors with out-of-pocket medical expenses and, in some cases, Medicare premiums, co-payments, and deductibles. Medicare is a federal health insurance program for individuals 65 and older, certain people with disabilities, and people with end-stage renal disease (ESRD). It is important to note that while Medicaid can provide additional coverage for some parts of Medicare, they are separate programs with different eligibility requirements.
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Frequently asked questions
OKDHS stands for Oklahoma Department of Human Services, which is the agency that administers Medicaid in Oklahoma.
Yes, you can apply for SoonerCare (Medicaid in Oklahoma) through OKDHS Live. You can also apply by calling the Director's Helpline at 877-751-2972 or 405-521-2779, or by contacting your local county office.
To be eligible for Medicaid in Oklahoma, individuals must meet certain income and other eligibility requirements. Medicaid is available for low-income individuals of all ages, including the elderly, blind, disabled, pregnant women, children, and parents.
It is not clear whether Medicaid insurance can be canceled. However, it is important to note that Medicaid eligibility is based on financial criteria, which changes annually and varies with marital status. Therefore, it is possible that an individual's Medicaid coverage could be discontinued if they no longer meet the eligibility requirements.
